Remote Patient Monitoring (RPM), also called remote physiologic monitoring, is a Medicare service that allows health care providers to collect and review physiologic data from patients using FDA-cleared medical devices outside of traditional clinical settings. The data transmits electronically from the patient's home or other location to the provider's practice, where clinical staff or the billing practitioner reviews it, communicates with the patient, and adjusts care plans as needed.
RPM was first separately reimbursable under Medicare in 2018, when CMS finalized payment for CPT codes 99453 and 99454 (device supply and data transmission) and 99457 (treatment management services). The program has expanded in subsequent years, with the addition of CPT 99458 for additional treatment management time, and two new codes finalized in the CY 2026 Physician Fee Schedule: CPT 99445 (device supply for 2-15 days of data) and CPT 99470 (treatment management for 10 minutes).
Eligible Patients:
Any Medicare beneficiary can participate in RPM. There is no minimum number of chronic conditions required, and CMS clarified in 2020 that RPM can be used for both chronic and acute conditions. Post-surgical monitoring, short-term medication adjustments, and transitional monitoring after hospital discharge all qualify if medically necessary. An established patient relationship (at least one face-to-face encounter in the prior year) is required before RPM services begin.
Devices:
RPM devices must meet the FDA's definition of a medical device. Common devices include blood pressure cuffs, pulse oximeters, weight scales, blood glucose monitors, and respiratory flow rate monitors. The devices must transmit daily recordings or programmed alerts electronically. CMS does not consider patient self-reported data to qualify for RPM (self-reported data falls under Remote Therapeutic Monitoring, or RTM).
Data Transmission Requirements:
For the device supply code CPT 99454, a patient must transmit data on 16 or more days within a 30-day billing period. The new CPT 99445 code, finalized for 2026, covers patients who transmit data on 2-15 days within a 30-day period. A provider must choose one or the other; they cannot bill both 99454 and 99445 for the same patient in the same period.
Measurement days are counted regardless of the number of devices. If a patient takes a blood pressure reading on Monday and a weight reading on Tuesday, that counts as two measurement days. Two readings on the same day count as one measurement day.
Treatment Management:
Treatment management codes (99457, 99458, 99470) are calendar-month codes that cover the time a clinical staff member, physician, or qualified health care professional spends reviewing data, communicating with the patient, and managing the care plan. All management codes require at least one real-time, interactive communication (phone or video) with the patient or caregiver during the month. CMS specifies that these must be live, two-way synchronous communications.
CPT 99470 (new for 2026) covers the first 10 minutes and cannot be billed with 99457 in the same month. CPT 99457 covers the first 20 minutes and may be combined with 99458 for additional 20-minute increments (up to two additional units per month).
Supervision:
RPM service codes are designated as care management services by CMS, allowing clinical staff to provide them under general supervision. The billing practitioner need not be physically present in the same office building; they must be available to answer questions or provide assistance.
Integration with Other Programs:
RPM can be billed alongside CCM, BHI, and other care management programs for the same patient, provided that each program's time and documentation requirements are met separately. Time spent on RPM management cannot be double-counted toward CCM or other service thresholds.
Only one practitioner can bill RPM device codes per patient per 30-day period. This prevents duplicate billing when a patient has multiple providers.
Sources:
CMS CY 2018-2026 Physician Fee Schedule final rules; CPT Code Manual;
42 C.F.R. § 414.2; CMS Medicare Learning Network, "Telehealth and Remote Patient Monitoring.
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